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Exploring Patient’s Perspectives and Experiences After Start with Inhalation Maintenance Therapy: A Qualitative Theory-Based Study

Authors Kuipers E, Wensing M, De Smet PAGM, Teichert M

Received 9 October 2019

Accepted for publication 3 January 2020

Published 29 January 2020 Volume 2020:14 Pages 203—212


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Esther Kuipers, 1, 2 Michel Wensing, 1, 3 Peter AGM De Smet, 1, 4 Martina Teichert 5

1Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of IQ Healthcare, Nijmegen 6500 HB, The Netherlands; 2BENU Apotheek Zeist West, Zeist, The Netherlands; 3University Hospital Heidelberg, Department of General Practice and Health Services Research, Heidelberg, Germany; 4Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of Clinical Pharmacy, Nijmegen, The Netherlands; 5Leiden University Medical Centre, Department of Clinical Pharmacy and Toxicology, Leiden, The Netherlands

Correspondence: Esther Kuipers
Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of IQ Healthcare, PO Box 9101, Nijmegen 6500 HB, The Netherlands
Tel +31 24 361 0591
Fax +31 24 354 0166

Background: Treatment of obstructive lung disease with inhalation therapy needs changes in patient behavior. Shortly after the start with inhaled corticosteroids (ICS) maintenance therapy, patients might be in need of additional pharmaceutical care, tailored to their individual needs. This study aimed to provide insight into patient behavior, goals and perceptions regarding their medical treatment at start with ICS therapy, by telephone interviews with ICS starters. Besides, this study investigated pharmacists’ and patients’ experiences with these interviews and opinions on the utility of this type of consultation for daily practice.
Methods: Semi-structured telephone interviews were conducted by pharmacists with adult patients 2– 3 weeks after starting ICS. The Theoretical Domain Framework (TDF) was used for data analysis and coding. Afterward, the patients and pharmacists were questioned about their experiences with the interview.
Results: Five pharmacists conducted interviews with 23 ICS starters. Except the domains “environmental context and resources”, “optimism”, and “reinforcement”, the remaining 11 domains in the TDF were addressed in the interviews. The majority of patients defined personal goals, which mainly addressed disease or symptom control (clinical goals). Some patients showed a lack of knowledge regarding the clinical indication or therapy duration. Views on beneficial medication effects differed between patients. Some patients specifically mentioned concerns or anxiety about side effects. The interviewees described different perceptions on the necessity of a personalized routine for regular medication use. Patients and pharmacists both felt positive about an added value of these interviews for daily practice.
Conclusion: Patient interviews shortly after start with ICS therapy revealed various perceptions and beliefs that might influence medication use and achievement of individual treatment goals. The patients appreciated the opportunity to ask questions and share their perspectives and needs with their pharmacist, and the pharmacists experienced that the interviews had added value.

Keywords: inhalation therapy, asthma, COPD, pharmaceutical care, pharmacy practice research, consultation, patient perspective

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